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Computerized assessment of complications after colorectal surgery

Is it valid?

  • Original Contributions
  • Published:
Diseases of the Colon & Rectum

Abstract

PURPOSE: Historically, complication rates after colorectal surgery have been stratified by disease process, type of operation, or anesthesia risk derived after an intensive review of the medical record. Newer computer applications purport to shorten this process and predict the probability of postoperative complications by distinguishing them from comorbidities that are commingled on uniform discharge codes. We analyzed CaduCIS™ software, which uses discharge codes, to determine whether its predictions of comorbidity and complications were comparable to what was interpreted on the medical record. METHODS: Two-hundred seventy patients were analyzed according to the principal and secondary diagnoses coded on discharge. Coding inaccuracies of clinical occurrences were identified by physician review of each medical record. The actual incidences of 17 common preoperative comorbidities and 11 postoperative complications were compared with those predicted by CaduCIS™. RESULTS: The CaduCIS™-predicted distribution of comorbidities was similar to the actual occurrences in 15 of 17 categories. The overall incidence of complications obtained by physician (actual) review was 47 percent, compared with 46 percent predicted by CaduCIS™. However, there was a statistical difference between the CaduCIS™-predicted and the actual complication rates in 5 of the 11 categories. The most common preoperative comorbidity and complication was cardiopulmonary (47 percent and 28 percent, respectively). CONCLUSION: The overall complication rate interpreted from the medical record (47 percent) was accurately predicted by CaduCIS™ (46 percent). Predictions of 5 of 11 individual complications were underestimated because of charting and coding inaccuracies, not because of computerized errors. Because uniform discharge coding of commingled comorbidity and complications is increasingly used to rapidly compute surgical outcomes, colon and rectal surgeons need to ensure compatibility of the actual and coded medical records.

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Authors and Affiliations

  1. Department of Surgery, Division of Colon and Rectal Surgery, From Lehigh Valley Hospital, Allentown, Pennsylvania

    Khawaja Azimuddin M.D. & Lester Rosen M.D.

  2. Department of Community Health & Health Studies, Allentown, Pennsylvania

    James F. Reed III Ph.D.

Authors
  1. Khawaja Azimuddin M.D.
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  2. Lester Rosen M.D.
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  3. James F. Reed III Ph.D.
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Azimuddin, K., Rosen, L. & Reed, J.F. Computerized assessment of complications after colorectal surgery. Dis Colon Rectum 44, 500–505 (2001). https://doi.org/10.1007/BF02234321

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  • DOI: https://doi.org/10.1007/BF02234321

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